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From Policy to Practice: A Retrospective Audit Evaluating Compliance with Duty of Candour in Health and Care Jersey.

Background: Duty of Candour (DoC) is a professional, ethical, and legal requirement in healthcare, mandating transparency, openness, and honesty when patients come to harm. Although statutory frameworks exist in parts of the UK, Jersey lacks local legislation, relying on organisational policy or professional codes, such as the Nursing and Midwifery Council, General Medical Council and Health and Care Professions Council. Despite the significance of DoC, studies indicate inconsistent understanding, interpretation, and application among healthcare professionals. Project design: A retrospective descriptive design was used for the clinical audit. Focusing on patient safety incidents that had been investigated as serious incidents, the audit measured compliance with DoC against the local policy. Key elements such as the provision of an apology, delivery of a formal letter, documentation, and timeliness of communication with patients and families were explored. Findings: Findings from the thirty-two cases illustrated 78% of patients and families were informed of the safety event as soon as possible, 50% were offered an apology and 34% of patients and families receiving reassurance that lessons would be learned. 72% of patients had no initial communication or apology documented in their records with less than 10% of patient’s ort their families receiving a formal letter of apology from the organisation. Conclusion: Despite having an organisational policy, challenges remain in fidelity of application. Improved training, clearer protocols, and improvements to policy are required to promote a culture of transparency. This study offers recommendations to improve consistency with the application of DoC which include to revision of the DoC policy, introduction of a standardised letter template and the delivery of multidisciplinary staff training

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